title: Previous prenatal loss as a predictor of perinatal depression and anxiety.
abstract: BACKGROUND
  Prenatal loss, the death of a fetus/child through miscarriage or stillbirth, is associated with significant depression and anxiety, particularly in a subsequent pregnancy.
  
  
  OBJECTIVE
  This study examined the degree to which symptoms of depression and anxiety associated with a previous loss persisted following a subsequent successful pregnancy.
  
  
  METHODS
  Data were derived from the Avon Longitudinal Study of Parents and Children cohort, a longitudinal cohort study in the west of England that has followed mothers from pregnancy into the postnatal period. A total of 13,133 mothers reported on the number and conditions of previous perinatal losses and provided self-report measures of depression and anxiety at 18 and 32 weeks' gestation and at 8 weeks and 8, 21 and 33 months postnatally. Controls for pregnancy outcome and obstetric and psychosocial factors were included.
  
  
  RESULTS
  Generalised estimating equations indicated that the number of previous miscarriages/stillbirths significantly predicted symptoms of depression (β = 0.18, s.e. = 0.07, P<0.01) and anxiety (β = 0.14, s.e. = 0.05, P<0.01) in a subsequent pregnancy, independent of key psychosocial and obstetric factors. This association remained constant across the pre- and postnatal period, indicating that the impact of a previous prenatal loss did not diminish significantly following the birth of a healthy child.
  
  
  CONCLUSIONS
  Depression and anxiety associated with a previous prenatal loss shows a persisting pattern that continues after the birth of a subsequent (healthy) child. Interventions targeting women with previous prenatal loss may improve the health outcomes of women and their children.
authors.affiliation: Department of Psychiatry, University of Rochester Medical Center, New York, NY 14642-8409, USA. Emma_robertsonblackmore@urmc.rochester.edu
authors.forename: Emma Robertson
authors.initials: ER
authors.lastname: Blackmore
authors.forename: Denise
authors.initials: D
authors.lastname: Côté-Arsenault
authors.forename: Wan
authors.initials: W
authors.lastname: Tang
authors.forename: Vivette
authors.initials: V
authors.lastname: Glover
authors.forename: Jonathan
authors.initials: J
authors.lastname: Evans
authors.forename: Jean
authors.initials: J
authors.lastname: Golding
authors.forename: Thomas G
authors.initials: TG
authors.lastname: O'Connor
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D001007:Anxiety / Q000453:epidemiology*; D019052:Depression, Postpartum / Q000453:epidemiology* / Q000523:psychology; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy / Q000523:psychology*; D012907:Smoking / Q000453:epidemiology; D050497:Stillbirth / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult